Not aibu but absolutely gutted about the mother and her baby found dead

[Goodmum1234]

I didn't know her but having only given birth ten weeks ago myself and now seeing her photo on the news I am devastated for her, her baby and her family ?? having had severe pnd four years ago I can see how things can go so wrong if no one knows how you feel and intervenes. RIP x

For anyone who didn't see this on the other thread about the same subject:

A few findings that might interest some of you, mainly from a report carried out by the London School of Economics and the Centre for Mental Health that was published last month:

1. One in five women develops some form of mental health issue during pregnancy and the months after childbirth.

2. For all births in one year, there is a long-term cost of £8.1bn stemming from mental health problems. (And the report's authors say this is a conservative estimate). Of the £8.1bn cost, a fifth was borne by the public sector including the NHS and social services. The remainder was estimated as a wider cost to society such as through lost earnings.

To put that into perspective the cost to the UK economy of overweight and obesity was estimated at £15.8 billion per year in 2007, including £4.2 billion in costs to the NHS.

3. There are significant gaps in the detection of mental health problems in the period before and after birth, with only an estimated 40% being diagnosed, with just 3% of women experiencing a full recovery

4. The cost of providing a service that met minimum National Institute for Health and Care Excellence guidelines across the country would be £337m a year.

5. Of 211 clinical commissioning groups in England, the regional organisations that partly replaced primary care trusts last year, just 3% have a formal strategy for perinatal mental health services, with a significant majority having no plans to implement one.

6. Talking therapies are seen as especially useful for milder cases of perinatal depression since many anti-depressants cannot be used while pregnant or breastfeeding, but there is currently capacity to treat just 15% of women in England who need such services.

7. Women can be treated in special mother and baby mental health units, but twice as many of these facilities are needed.

8. The Maternal Mental Health Alliance carried out a parallel audit of perinatal mental health services around the country with the Royal College of Psychiatrists.

It found no specialist service at all in 40% of areas in England and Scotland, rising to 70% on Wales and 80% in Northern Ireland. Fewer than 15% of the UK had comprehensive provision.

9. There is very wide disparity in care throughout the NHS which is highlighted by London; seven of the 32 areas had highest-level services, but nine provided none.

We do not need to security tag babies or lock pregnant / postnatal women with mental health problems up. We need services and staff who can support them, we need women to be aware of services that can help them, and we need to remove the stigma and fear that women have if they have mental health issues.

The MMHA launched a campaign last month to highlight the issue. maternalmentalhealthalliance.org.uk/ They published a map which shows which areas are performing better than others, which can be found here: everyonesbusiness.org.uk/?page_id=349

I don't know why this woman died, but no one would walk out a hospital like that if they were well. And I think its wrong to point the finger of blame at staff when there is clearly a huge issue that isn't being addressed properly by the NHS.

I've just read 2 more stories on the BBC re babies being found dead, the mothers are receiving treatment, no one else is being sought in connection.
Additionally in Alva a 5yo boy is dead and his mum has been detained. So that's 4 just in the last few days

Obviously I am not in a position to know the facts of these, but I do wonder if something all of a sudden is going badly wrong with MH provision for mothers

It doesn't seem very fair to me that midwives are expected to provide peri-natal psychiatric care.

Surely there is a gap in provision? There must be thousands of new and expectant mothers who could do with a higher level of support, but ATM, unless they are unwell enoughto be detained under section, there is no provision at all. I s that right?

I haven't stopped thinking of them since the news broke. As others have said, that could easily have been me. I had post-natal psychosis after the birth of my son, but went undiagnosed for some time because I was excellent at faking. I will never forget those nights in my side room off the hopelessly over stretched post-natal ward, when I was having full-blown hallucinations. I suspect the only reason I didn't walk out like Charlotte is because I physically couldn't post-CS. The thing I honestly don't know about - and it's tormented me for the last few days - is whether or not I would have taken my baby or left him.

There are a lot of us.

Midwives do not perform peri-natal psych care.

If a mum is known to services she will be visited on the ward by her pdoc and/or CPN.

If a mum is not known to services and her behaviour raises concerns the midwives, the midwife refers to the obs/gynae docs who work on the ward and they make an assessment and if needed refer to liason psychiatry.

Same if a patient was acting strangely on a surgical ward. The first people to be aware of odd behaviour tend to be the nurses, then they refer to the junior surgeon who will assess and refer to liason psych, who come to the ward and do a formal assessment.

So would some middle way be beneficial? (For those with pre-existing DXs like Charlotte Bevan and those identified as needing extra support once admitted)

Maternity unit with psych nurses and midwives, for e.g.?

I think it is right that mothers are free to leave the ward with their babies whenever they want - I don't think "security" (restricting women's movements) is the issue.

I suspect if there were failings it will be down to understaffing and stretched budgets. Sadly it will probably be easier to find some poor midwife to scapegoat.

In an ideal world this bad news would mean cuts to MH services are stopped and more support is given to women with a MH history in pregnancy.

In an ideal world they would open up more MABUs as there are only 7 UK wide.

However I predict cuts will continue to happen and the only difference is social workers will be a lot proactive with ladies who have MH issues and get pregnant.

Just like after Baby P this will result in a knee jerk reaction and babies getting taken at birth on the basis of "future risk".

If you think that living is so awful that you cannot do it any longer, you see taking your baby with you as a kindness, saving them from the pain that you are experiencing. The only thing worse for them than to remain alive would be to remain alive without you to look after them.

It made perfect sense to me once. My baby and I were lucky. I got through it.

BeHoHoHove, in the last day three people on my Facebook have posted about separate campaigns to save/reinstate mental health beds for women (not new mothers in particular) that have been closed/are under threat of closure, all in different areas (Norfolk, Suffolk, Lancaster). I don't have a huge circle of friends and no particular connection with mental health professionals, it just seems like everyone is trying to save money by cutting women's mental health beds and women who know how serious the consequences can be are very frightened indeed about what will happen when there is nowhere for them to go.

As for poor Charlotte, obviously we don't know what happened, but if wards are understaffed it's obvious that mental health symptoms are going to be missed.

It does feel like things have hit crisis point tbh.

I got Dx with bipolar 10 years ago and in that 10 years I have seen MH services decimated for men and women with serious psychiatric problems.

Most of the cuts started about 3 years ago and things are getting far far worse.

I got discharged from psych care end of last year and was told I had made a full recovery. Although I am very pleased about this I do question whether cut backs were involved in my discharge.

The only change which will happen as a result of this is more babies being removed at birth when a woman has a MH issue. So Charlotte's death is likely to make things worse, not better.

The problem is there is a limited (and shrinking) pot from which all MH services have to be funded. The sad truth about mental illness in women is it tends to manifest in self harm, and very occasionally in harm to dependents. Mental illness in males is more likely to result in violent, damaging and criminal behaviour, and therefore gets more attention and subsequently money.

I feel desperately sorry for all involved, and hope this doesn't become a witch-hunt against individual care staff. By the time she got to the vending machines, she was already off the ward and therefore anyone who saw her would assume she had already spoken to a member of staff.

I do not believe you should be saying unwell mums are more likely to harm children than unwell dads, unless you can back that up with a citation.

I have never come across that before.

I also want to add that the vast majority of people who harm children do NOT have mental health issues.

No, that's not what I said at all. I said that women who cause harm due to mental illness are much more likely to harm themselves than others. Men are proportionally more likely to harm others in addition to harming themselves.
This is regardless of familial status. Therefore, in a shrinking pot, more money proportionally is allocated to services to prevent harm to others.

This whole story just highlights the woefully antiquated way our postnatal wards are run. Dads sent home after 9pm? In whose world is that a good idea, when a couple are separated at the precise moment in their life when their every instinct is to be together as a family to start their new life together.

There's quite a good chance that had the baby's dad been allowed to stay 24/7, he might have spotted signs that all was not well with her mental health. He would be the one who knew her best and who would immediately know if something she did or said was out of character for her. He could have alerted staff. Overworked strangers may well have checked on her half an hour but they didn't KNOW her. They didn't know what was normal for her.

Oh we always get the argument on here that new mums shouldn't have to put up with strange men on the ward when they're in their nightie with leaky boobs and leaky undercarriage, but why can't postnatal wards consist of all private rooms with a bed for the dad (or other close relative) to stay, for emotional support and badly-needed practical support (there will be many women on here who can remember the horrors of not being able to physically get out of bed to care for their crying baby as there were no staff available.)

Oh I know there are funding implications in setting up family rooms, but ultimately it might actually take the pressure OFF overworked staff quite a bit if new mums are getting help from their spouse/mother.

In an ideal world they would open up more MABUs as there are only 7 UK wide.

Seven!?

Just like after Baby P this will result in a knee jerk reaction and babies getting taken at birth on the basis of "future risk".

I see what you mean.

I wonder if something like MH doulas would work? (Just thinking aloud). The NHS is fabulous but it is such a behemoth. Someone with Charlotte might have made the difference.

pacific and living sorry for not responding to you both earlier - thanks for the good wishes and yes I think we do all agree :)

i have no qualms at all about giving birth in this hospital shortly and my experience of the MH care is that it is excellent, so I trust that the postnatal MH follow up I am due to receive will probably be better than adequate.

if anyone is interested, there is a local Bristol charity called Mothers for Mothers, staffed by previous PND sufferers, who are currently fundraising because their lottery funding has been cut. They run a helpline and go into hospitals to talk to new mothers. If you are inclined towards making a donation off the back of this sad tragedy I'm sure they would be very grateful. I should note that the family have not suggested this - it's just that the charity is suddenly receiving a lot of local attention at the moment, given that a friendly volunteer on the ward to talk to can do vulnerable mothers a lot of good.

Thanks Pom

mothersformothers.co.uk/

Curly, DH was allowed to stay with me when I had DS for that exact reason.

This idea of a shrinking pot of funds is a misleading one, if inadequate services are costing us more in the long run anyway which seems to be the case.

It doesn't seem very fair to me that midwives are expected to provide peri-natal psychiatric care. Surely there is a gap in provision?

There is. Of midwives who specialise in this area. I was under the care of a great lady who no longer delivers babies but instead focuses on issues for pregnant women. Sadly however not all places have someone who does this.

More generally though I do think there is a gap in training in midwifery, which needs to be addressed to give them a more basic level knowledge. I think nurses in other areas of health care should do it too as its something that's an essential part of any kind of health care. Our bodies and minds are not separate.

For people who question how she could take her baby with her let me tell you my story.

After having DS1 I was hit with very severe PND. I wanted to die every second I was awake. However, I didn't want DS1 to grow up knowing that I'd killed myself and perhaps thinking I didn't love him enough. It's symptomatic of how ill I was that my solution to this was to take him with me when I committed suicide (I was going to walk us under a bus).

Thankfully I had an amazing HV & GP and we got through it. But PND makes your thoughts irrational-at the time killing myself and the baby made perfect sense, now I feel sick that I ever could have thought about it for a second.

I feel for the family so much & I hope some lessons are learnt from Charlotte and her baby's tragic deaths.

This whole story just highlights the woefully antiquated way our postnatal wards are run. Dads sent home after 9pm? In whose world is that a good idea, when a couple are separated at the precise moment in their life when their every instinct is to be together as a family to start their new life together.

There was a huge thread about this very subject a few months ago, and there were many many people who, for various reasons, strongly believed that fathers should not be allowed to stay overnight in post natal wards.

Personally I would have loved it if DH could have stayed with me, because both times I was only in for one night but they were two of the most horrible nights of my life and I would have loved him there. But I know not everyone feels that way.

After having DS1 I was hit with very severe PND. I wanted to die every second I was awake. However, I didn't want DS1 to grow up knowing that I'd killed myself and perhaps thinking I didn't love him enough. It's symptomatic of how ill I was that my solution to this was to take him with me when I committed suicide (I was going to walk us under a bus).

I don't even think you need to be suicidal to understand how it makes sense.

I have never been suicidal, but I have, in some darker moments like most people probably, pondered that the world would be a better place without me in it. But then my immediate following thought is that I could never put my kids through that and have them think I didint love them (I have taught two children whose parents committed suicide and the consequences for them were just devestating). So then, for a fleeting moment while I am pondering these things, I think if I was going to do it it would be better to take them with me (god I hope that makes sense).

This is me, as someone who has never had any significant mental health issues, thinking like that. I can totally understand why people think its a good idea to take their children with them

Hugs to all those who have suffered or are still suffering. Our stories are heartbreaking but your strength is inspirational xxx

bigcatface if you are a MN blogger you can link. Just request to be added if you haven't already. It's a great resource :) I too have bipolar and keep a blog which discusses at length some of these issues, particularly medication during pregnancy and instance rates of pre and postpartum mental health episodes demonicdivas.wordpress.com/

I had my baby in The Netherlands. I had terrible HG on top of it all and the HG thread in the Pregnancy forum kept me and several others with the real world. There were some of us overseas with MH issues swapping stories about the differences between the UK and elsewhere. Since I have been back I have had a grand total of half an hour with a psychiatrist over the last five months as my appointment was booked incorrectly, a rushed review of my medication and out the door again. Fortunately I have a good GP which has helped.

As to allowing dads on the ward, even in a private room DH was not allowed to stay. They bent the rules massively to let him stay with me for two nights when dd was first in ICU as I was so unwell I couldn't function without him (I was in for eight days). It was simply the hardest thing possible for me to go through. I couldn't be with my baby and I couldn't be with my husband. I just lay there staring at the clock waiting until they'd deemed I had enough rest to head down to the ICU again. It was also awfully hard for me to see all these healthy babies and healthy mothers on the ward whilst I was sick and my baby was sick.

I can see why some wards wouldn't allow men, but when there is a MH issue it can be very challenging and dangerous for women to be left alone. So it just comes down to a lack of resource again. Bah, I have no answers. Just frustration.

I don't like the way various relatives and friends are blaming the hospital. They knew her issues, where were they in all of this?

I agree that it could have been so different if her dp had been allowed to stay with her. I don't think any woman should be left to care for a newborn alone especially not women who are at a higher risk of mh issues.

I do understand the men on a public ward issue but as the visiting rules are so relaxed in the uk in the daytime it seems women have to put up with extended families and random friends visiting in the day, surely less open visiting (maybe one or 2 named visitors) but 24 hour visiting would be a good compromise. Another solution could be to only allow a female support person, maybe a mum, sister of friend.